Utility of C-arm CT in Patients with Hepatocellular Carcinoma undergoing Transhepatic Arterial Chemoembolization

Alessia Tognolini, John D. Louie, Gloria L. Hwang, Lawrence V. Hofmann, Daniel Y. Sze, Nishita Kothary

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the utility of C-arm computed tomography (CT) on treatment algorithms in patients undergoing transhepatic arterial chemoembolization for hepatocellular carcinoma (HCC). Materials and Methods: From March 2008 to July 2008, 84 consecutive patients with HCC underwent 100 consecutive transhepatic arterial chemoembolizations with iodized oil. Unenhanced and iodinated contrast medium-enhanced C-arm CT with planar and three-dimensional imaging were performed in addition to conventional digital subtraction angiography (DSA) in all patients. The effect on diagnosis and treatment was determined by testing the hypotheses that C-arm CT, in comparison to DSA, provides (a) improved lesion detection, (b) expedient identification and mapping of arterial supply to a tumor, (c) improved characterization of a lesion to allow confident differentiation of HCC from pseudolesions such as arterioportal shunts, and (d) an improved evaluation of treatment completeness. The effect of C-arm CT was analyzed on the basis of information provided with C-arm CT that was not provided or readily apparent at DSA. Results: C-arm CT was technically successful in 93 of the 100 procedures (93%). C-arm CT provided information not apparent or discernible at DSA in 30 of the 84 patients (36%) and resulted in a change in diagnosis, treatment planning, or treatment delivery in 24 (28%). The additional information included, amongst others, visualization of additional or angiographically occult tumors in 13 of the 84 patients (15%) and identification of incomplete treatment in six (7.1%). Conclusions: C-arm CT is a useful collaborative tool in patients undergoing transhepatic arterial chemoembolization and can affect patient care in more than one-fourth of patients.

Original languageEnglish (US)
Pages (from-to)339-347
Number of pages9
JournalJournal of Vascular and Interventional Radiology
Volume21
Issue number3
DOIs
StatePublished - Mar 2010
Externally publishedYes

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Hepatocellular Carcinoma
Tomography
Digital Subtraction Angiography
Therapeutics
Ethiodized Oil
Three-Dimensional Imaging
Contrast Media
Neoplasms
Patient Care

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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Utility of C-arm CT in Patients with Hepatocellular Carcinoma undergoing Transhepatic Arterial Chemoembolization. / Tognolini, Alessia; Louie, John D.; Hwang, Gloria L.; Hofmann, Lawrence V.; Sze, Daniel Y.; Kothary, Nishita.

In: Journal of Vascular and Interventional Radiology, Vol. 21, No. 3, 03.2010, p. 339-347.

Research output: Contribution to journalArticle

Tognolini, Alessia ; Louie, John D. ; Hwang, Gloria L. ; Hofmann, Lawrence V. ; Sze, Daniel Y. ; Kothary, Nishita. / Utility of C-arm CT in Patients with Hepatocellular Carcinoma undergoing Transhepatic Arterial Chemoembolization. In: Journal of Vascular and Interventional Radiology. 2010 ; Vol. 21, No. 3. pp. 339-347.
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abstract = "Purpose: To evaluate the utility of C-arm computed tomography (CT) on treatment algorithms in patients undergoing transhepatic arterial chemoembolization for hepatocellular carcinoma (HCC). Materials and Methods: From March 2008 to July 2008, 84 consecutive patients with HCC underwent 100 consecutive transhepatic arterial chemoembolizations with iodized oil. Unenhanced and iodinated contrast medium-enhanced C-arm CT with planar and three-dimensional imaging were performed in addition to conventional digital subtraction angiography (DSA) in all patients. The effect on diagnosis and treatment was determined by testing the hypotheses that C-arm CT, in comparison to DSA, provides (a) improved lesion detection, (b) expedient identification and mapping of arterial supply to a tumor, (c) improved characterization of a lesion to allow confident differentiation of HCC from pseudolesions such as arterioportal shunts, and (d) an improved evaluation of treatment completeness. The effect of C-arm CT was analyzed on the basis of information provided with C-arm CT that was not provided or readily apparent at DSA. Results: C-arm CT was technically successful in 93 of the 100 procedures (93{\%}). C-arm CT provided information not apparent or discernible at DSA in 30 of the 84 patients (36{\%}) and resulted in a change in diagnosis, treatment planning, or treatment delivery in 24 (28{\%}). The additional information included, amongst others, visualization of additional or angiographically occult tumors in 13 of the 84 patients (15{\%}) and identification of incomplete treatment in six (7.1{\%}). Conclusions: C-arm CT is a useful collaborative tool in patients undergoing transhepatic arterial chemoembolization and can affect patient care in more than one-fourth of patients.",
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N2 - Purpose: To evaluate the utility of C-arm computed tomography (CT) on treatment algorithms in patients undergoing transhepatic arterial chemoembolization for hepatocellular carcinoma (HCC). Materials and Methods: From March 2008 to July 2008, 84 consecutive patients with HCC underwent 100 consecutive transhepatic arterial chemoembolizations with iodized oil. Unenhanced and iodinated contrast medium-enhanced C-arm CT with planar and three-dimensional imaging were performed in addition to conventional digital subtraction angiography (DSA) in all patients. The effect on diagnosis and treatment was determined by testing the hypotheses that C-arm CT, in comparison to DSA, provides (a) improved lesion detection, (b) expedient identification and mapping of arterial supply to a tumor, (c) improved characterization of a lesion to allow confident differentiation of HCC from pseudolesions such as arterioportal shunts, and (d) an improved evaluation of treatment completeness. The effect of C-arm CT was analyzed on the basis of information provided with C-arm CT that was not provided or readily apparent at DSA. Results: C-arm CT was technically successful in 93 of the 100 procedures (93%). C-arm CT provided information not apparent or discernible at DSA in 30 of the 84 patients (36%) and resulted in a change in diagnosis, treatment planning, or treatment delivery in 24 (28%). The additional information included, amongst others, visualization of additional or angiographically occult tumors in 13 of the 84 patients (15%) and identification of incomplete treatment in six (7.1%). Conclusions: C-arm CT is a useful collaborative tool in patients undergoing transhepatic arterial chemoembolization and can affect patient care in more than one-fourth of patients.

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